RECORD OF PROCEEDINGS AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS IN THE MATTER OF: DOCKET NUMBER: BC-2014-01536 COUNSEL: NONE HEARING DESIRED: NO APPLICANT REQUESTS THAT: 1. His honorable discharge be changed to a medical retirement with retroactive retirement benefits. 2. His appointment to sergeant be restored. APPLICANT CONTENDS THAT: He has Post-Traumatic Stress Disorder (PTSD) which was not properly diagnosed. The Department of Veterans Affairs (DVA) has since confirmed that he, in fact, had PTSD and he should have been medically discharged with retirement compensation and medical benefits. Also he should not have received a reduction in rank because of the military doctor’s inability to diagnose his condition of PTSD. He has been battling this since his separation (28 Feb 86) and continues to receive treatment for PTSD at the Tuscaloosa VA Medical Center in Tuscaloosa, Alabama. The Board should find it in the interest of justice to consider his untimely application because he was wrongfully discharged and has been fighting this since his discharge; he has PTSD that was misdiagnosed by the military and the DVA finally got it right and he now receives 30 percent disability; however, he should have been medically retired with retroactive benefits. The applicant’s complete submission, with attachments, is at Exhibit A. STATEMENT OF FACTS: On 23 Jan 79, the applicant initially entered the Regular Air Force for a period of four years. On 1 Oct 81, the applicant was promoted to the grade of Senior Airman (SrA/E-4). On 1 Oct 82, he appointed Non-Commissioned Officer (NCO) status as a Sergeant (Sgt/E4). On 31 Jan 86, the squadron commander notified the applicant of administrative discharge action for conditions that interfere with military service: character and behavior disorders. The specific reasons for the proposed action was that on or about 23 Jan 86, the applicant was diagnosed with Axis I, Agoraphobia with Panic attacked; Axis II, Mixed Personality Disorder with Passive, Aggressive and Avoidant; Axis III, Seizure Disorder; Axis IV, Minimal Psychosocial Stressors, and Axis V, Poor Adaptive Functioning, as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and it was determined that the discharge was deemed in the best interest of the Air Force. On that same date, the applicant acknowledged receipt of the discharge notification. On 4 Feb 86, the applicant’s NCO status was vacated in accordance with the governing Air Force directive. On 13 Feb 86, after consulting with counsel, the applicant waived his rights to a hearing before an administrative discharge board and to submit statements in his own behalf. On 18 Feb 86, the Staff Judge Advocate (SJA) found the case file legally sufficient to support separation and recommended the discharge, without probation and rehabilitation. The discharge authority accepted the unconditional waiver and directed the applicant be honorably discharged, without probation and rehabilitation. On 28 Feb 86, the applicant was furnished an honorable discharge and was credited with 7 years, 1 month, and 6 days of active service. AIR FORCE EVALUATION: AFPC/DPFD recommends denial indicating the preponderance of evidence reflects the Physical Disability Division never received a referral to the Physical Evaluation Board (PEB) and therefore could not have processed the case or given the applicant a medical retirement/separation. The complete DPFD evaluation is at Exhibit C. AFPC/DPSOE recommends denial indicating there is no error or injustice to correct since the applicant was not demoted to the grade of Airman First Class (A1C/E-3) as he contends. DPSOE notes the applicant was promoted to SrA on 1 Oct 81 and received his NCO status to Sgt (E-4) on 1 Oct 82. On 4 Feb 86, the applicant's commander notified him that his NCO status had been vacated. In accordance with AFR 35-16, paragraph 8-18a, a mandatory vacation of NCO status is required for involuntary discharge action, which had been initiated. The complete DPOSE evaluation is at Exhibit D. AFPC/DPSOR recommends denial. DPSOR notes that based on the documentation on file in the master personnel records, the discharge to include the separation code, the narrative reason for separation and character of service was consistent with the procedural and substantive requirements of the discharge instruction and was within the discretion of the discharge authority. DPSOR found no evidence of an error or injustice in the processing of the applicant's discharge. The complete DPSOR evaluation is at Exhibit E. The BCMR Medical Consultant recommends denial. The Medical Consultant is aware of recent policies and Congressional interest governing assessment of individuals who received an under other than honorable conditions [or less than honorable] discharge, who has since been diagnosed with and received service connection for Post-Traumatic Stress Disorder (PTSD); but particularly those who participated in combat operations; whether Vietnam era or the recent wars in Iraq and Afghanistan. Moreover, current policy also dictates that when a Personality Disorder is considered the cause for separation, the mental health assessment must be conducted by a psychiatrist or PhD- level psychologist, or words to that effect. In the case under review, the applicant did not receive an under other than honorable conditions or less than honorable discharge, he was not a participant in combat operations [per review of EPRs], and, his mental health evaluation was conducted by a PhD-level psychologist. The Medical Consultant acknowledges the applicant's report of being granted service connection for PTSD. However, even when considering possible overlapping symptoms of PTSD, Panic Disorder, and Anxiety Disorder, military officials determined that it was his co-morbid Personality Disorder that presented the greatest obstacle to his treatment and retention and, thus, recommended the administrative discharge. Therefore, it should be acknowledged that medical officials at the applicant's servicing medical facility did take into consideration that the applicant had an Axis I medical condition that warranted a Medical Evaluation Board (MEB). However, upon review by the officials at the Air Force's flagship medical facility, a medical board was deemed not appropriate. In addition, it should be noted that the DVA also does not recognize a developmental Personality Disorder as a compensable medical condition. Nevertheless, the Medical Consultant concedes that since a Personality Disorder is developmental in origin, one would expect this to have raised its appearance much sooner in the applicant's military career; noting the previous successful enlistment period beginning in 1979. In any case, absent a compensable medical condition as the primary impediment to duty or the cause for discharge, it appears that military command and medical officials acted within their authority to recommend an administrative discharge, under AFR 39-10, instead of a medical separation, under AFR 35-4 [forerunner of today's AFI 36-3212]. The applicant is advised that the Department of Veterans Affairs (DVA), under 38 C.F.R., Section 4.125, describes steps to be taken when there is disagreement in a mental health diagnosis in the following: (a) "If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the findings on the examination report, the rating agency shall return the report to the examiner to substantiate the diagnosis; (b) If the diagnosis of a mental disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination." No such analysis and conclusion have been presented by a competent military, civilian, or a VA mental health authority in the applicant's case. The applicant is also advised that the Military Department, operating under Title 10, United States Code (U.S.C.), bases its actions upon the evidence present at the "snap shot" time of final military disposition. To the contrary, the DVA, operating under a different set of laws [Title 38, U.S.C.] with a different purpose, is authorized to offer service connection and compensation for any medical condition that it establishes a nexus with military service, without regard to the narrative reason for release from service or the length of time transpired since discharge. The DVA is also empowered to conduct periodic reevaluations for the purpose of adjusting the disability ratings at the level of impairment for a given medical condition may vary over the lifetime of the veteran. The Medical Consultant notes that the applicant's petition has been markedly delayed under the law and that any "new" evidence procured through interview, does not automatically invalidate the information disclosed, observed behavior, and analyses (pl.) made at the time of his military service. The complete BCMR Medical Consultant evaluation is at Exhibit F. The Clinical Psychology Consultant recommends denial. The Clinical Psychology Consultant recognizes the applicant’s contention that he was diagnosed with PTSD by the VA, although supporting documentation was not included in the materials reviewed for this case. Regardless of the diagnosis, this Consultant reminds the Board that a diagnosis alone does not render a Service member unfit for continued military service. The proposed treatment for his anxiety disorder in 1985 was appropriate regardless of the differential diagnosis (e.g., PTSD vs. Panic Disorder). Systematic desensitization proposed to treat his panic attacks fits well within prolonged exposure protocols currently employed for treating PTSD. What appears to have stalled treatment was the applicant’s lack of motivation for services despite the problems his symptoms may have caused him at work. The medical providers in this case did not move straight to a recommendation for administrative separation. They first sought input on the appropriateness of a medical board and it was determined that such a board was not required. His personality characteristics were noted to be interfering with the treatment process and such features are not compensable. Therefore, he was subjected to administrative separation IAW AFR 39-10. The applicant offered no contention at that time and submitted an unconditional waiver for his right to a discharge board. His argument that he has been fighting the discharge since his release from service does not appear to be supported by the supplied documentation. The applicant is advised that a diagnosis or disability rating from the VA does not equate to a Military Department decision that he was unfit for continued military service for the same condition at the time of his discharge. The Military Department operates under Title 10, United States Code (U.S.C.) and must base its decisions on the “snap shot” in time of the Service member’s final disposition. In this case, the impact of the applicant’s anxiety disorder on his fitness for duty was not deemed to meet the threshold for disability evaluation system processing. At the snap shot of final disposition his non- compensable personality disorder was viewed as driving significant treatment complications and prevented efforts to return him to full duty and thus necessitated administrative separation. On the other hand, the VA operates under Title 38 U.S.C. with a different mission and picks up where the Military Department, by law, must leave off. The VA is authorized to compensate a Veteran for any medical condition for which it has established a nexus with military service regardless of the time that has passed since discharge or progression of the condition. Unlike the Military Department, the VA may conduct periodic reassessments of the condition and adjust its ratings accordingly. The complete Clinical Psychology Consultant evaluation is at Exhibit G. APPLICANT'S REVIEW OF AIR FORCE EVALUATION: Copies of the Air Force evaluations were forwarded to the applicant on 7 Jul 15 for review and comment within 30 days (Exhibit H). As of this date, no response has been received by this office. THE BOARD CONCLUDES THAT: 1. The applicant has exhausted all remedies provided by existing law or regulations. 2. The application was not timely filed; however, it is in the interest of justice to excuse the failure to timely file. 3. Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice. We took notice of the applicant’s complete submission in judging the merits of the case; however, we agree with the opinions and recommendations of the Air Force offices of primary responsibility and both the BCMR Medical Consultant and the BCMR Psychology Consultant and adopt their rationale as the basis for our conclusion the applicant has not been the victim of an error of injustice. Additionally, the Board found no evidence to support the applicant’s contention to reinstate his vacated NCO status. Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the requested relief. THE BOARD DETERMINES THAT: The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; and the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application. The following members of the Board considered AFBCMR Docket Number BC-2014-01536 in Executive Session on 27 Aug 15 under the provisions of AFI 36-2603: , Panel Chair , Member , Member The following documentary evidence was considered: Exhibit A. DD Form 149, dated 9 Jul 13, w/atchs. Exhibit B. Applicant's Master Personnel Records. Exhibit C. Letter, AFPC/DPFD, dated 13 May 13 [sic]. Exhibit D. Letter, AFPC/DPSOE, dated 16 May 14. Exhibit E. Letter, AFPC/DPSOR, dated 11 Jun 14. Exhibit F. Letter, BCMR Medical Consultant, dated 5 Nov 14. Exhibit G. Letter, BCMR Psychology Consultant, dated 22 Jun 15. Exhibit H. Letter, SAF/MRBR, dated 7 Jul 15. 7